Ontario and Quebec are the most vocal critics of a new health funding formula because their own budgets are hemorrhaging red ink, says an expert on finances from the western home of medicare.

"It's much easier to blame the federal government for their problems than to actually sit down and address their own situation, their own spending," says Janice MacKinnon, a former finance minister in Roy Romanow's NDP government.

Now a University of Saskatchewan fiscal policy professor, MacKinnon says Canada's two largest provinces are failing at righting their economies.

She described Monday's no-strings deal as "very fair" and "reasonable" compared to the present transfer agreement that calls for annual transfers of 6% - a figure Finance Minister Jim Flaherty says is unsustainable.

Ontario and Quebec finance ministers hyperventilated over the deal that gives the provinces five years to fix their systems before the new funding arrangement kicks in - one that ties funding to GDP growth and never slips below 3%.

Both provinces are broke and the economic outlook is grim - hence the provinces wagging a finger on one hand and stretching out the other hand for more cash.

MacKinnon says the 2004 original deal was flawed from the outset because the biggest chunk went to salaries, with some of it used to lower wait times, but not to the broader issue of fixing the health system.

With an aging population and all that comes with that demographic, MacKinnon says provinces are out of touch with health needs and service delivery.

She points to the cost of MRIs, hip and knee replacements and other ailments that develop with age. A Saskatchewan study suggested millions in savings if some of those procedures were conducted outside hospitals.

"You really have to get serious about changing your system to make it more affordable," she said.